Patients undergo lymphoscintigraphy, which consists of technetium Tc 99m human serum albumin
colloid being injected near the tumor. Dynamic imaging using a gamma camera is performed for
20 minutes postinjection and static images are obtained for up to 3 hours postinjection.

Surgery is performed within 24 hours of lymphoscintigraphy. Patients are injected with
patent blue V dye near the tumor and a gamma detection probe is used to measure radioactive
counts in the sentinel node. Surgery begins within 5 minutes of the patent blue V dye
injection.

All lymph nodes that stain blue or have a high radioactive count are removed. The primary
breast lump is removed by either wide local excision or mastectomy and the axilla are
cleared by standard axillary dissection.

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